December 11, 2008

First Baby Born Through Full Ovary Transplant

Doctors are celebrating the first successful ovary transplant from a volunteer, allowing her infertile twin sister to give birth to a healthy baby girl on November 11.

The researchers said it is the first time an entire ovary has been transplanted and resulted in a live birth.

The method may offer a way to preserve fertility for cancer patients or for women who want to wait until they are older to start families, the researchers wrote in the New England Journal of Medicine.

Dr. Sherman Silber of the Infertility Center of St. Louis and his colleagues reported that one twin went into early menopause at age 15, but the transplanted ovary from her sister restored full fertility and she gave birth at the age of 38.

The team has previously transplanted the outer shell of the ovary and found that, even if the tissue is frozen, it can restore fertility.

Those techniques have proven successful so far for six babies that were born to eight women, but about two-thirds of the eggs die from lack of blood flowing through the tissue, and the women quickly slip into menopause after about three years.

However, the Silber team sought to avoid those problems by using a full ovary and reconnecting two veins and one artery to feed the graft, which is a challenge because the blood vessels are so tiny.

Although the work has involved identical twins where one had become prematurely infertile, the technique could eventually benefit two groups of women if frozen ovaries turn out to be as viable, Silber said.

"One is the young cancer patient who is about to lose all her ovarian function as she's about to undergo chemotherapy. We just take that ovary out, freeze it and transplant it back. That's one big payoff," he said.

But he said the other is more controversial: extending the time a woman is fertile. He said women in their 20s could have one of their two ovaries removed so it can be frozen.

"If she's 40 or 45 when she has it transplanted back, it's still a 25- or 30-year-old ovary, so she's preserving her fertility," he said. "We've actually done it for quite a few patients. I think there will be many more women who will want to do that."

Silber said the infertility rate at age 25 is only about 6 percent. It jumps to 70 percent by age 40 and is about 95 percent at age 43.